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Erythrocyte Sedimentation Rate (ESR, sed rate or “Biernacki reaction”) is a non-specific measure of inflammation that is commonly used as a medical“in vitro”screeningtest.

The test was invented in

1897 by the Polishphysician Edmund Biernacki and publishedin Polish. In 1918 Swedish pathologist Robert Fåhræus declared the same and along with AlfVilhelm Westergren published in English.

Anticoagulated whole blood in tube separates into an upper layer of plasma and lowerlayer of blood cells because of gravity. Erythrocytes are heavier (their specific density-weightis about 1.090kg/L and suspended in lighter plasma (which specific density-weight is about1.027kg/L).

The distance that cells fall

(sedimentate)

within a specified time interval (usually1hour) is defined as erythrocyte sedimentation rate (ESR). The rate ofsedimentation

of asingle erythrocyte is 0.2 mm/h but in vivo the sedimentation rate is higher, usually

1-2 mm/h.

In normal conditions erythrocytes settle faster because they aggregate